
Case Study: How Direct Patient Insights Empower Providers to Improve Quality Performance
Ensure compliance with advanced analytics and flexible member engagement solutions enabling efficient and accurate documentation of member conditions.
Over 15 years of industry experience and expertise empowering health plans across all lines of business to achieve risk score accuracy.
Inovalon delivers a scalable, end-to-end risk score accuracy solution that can be tailored to meet your unique program needs. We work with you to design a program that ensures the accuracy of your members’ risk scores.
Create your own cohorts and run predictive gap identification and intervention planning analytics on-demand to identify and address emerging and suspected patient-specific diagnoses.
Implement proven education and multi-channel intervention strategies and solutions that support a more comprehensive patient assessment and accurate disease and comorbidity burden documentation.
Proactively manage claims processing at various stages throughout the submissions process and monitor the financial impact of claims in error or not submitted to ensure accurate and timely submissions.
Improve risk score accuracy with machine learning-trained analytics that leverage historical data, trends, and past performance to identify member diagnoses that may be incompletely or improperly reflected within claims data systems and abstracted medical records.
Gain insights informed by data for more than 361 million patients, enabling effective documentation gap closure and informed strategic decision making.
Leverage Inovalon’s Converged Patient Assessment software to deliver claims history and member-specific gaps at the point of care to improve disease documentation and risk score accuracy.
Access deep member insights to drive highly-targeted, tailored interventions that offer members flexibility and choice to select the right encounter venue for them.
Inovalon has over 15 years of policy, regulatory compliance, and clinical experience to deliver expert program oversight and ensure compliant program execution.
Maximize risk score accuracy and ensure accurate financial performance with a comprehensive, end-to-end solution or one tailored to supplement your current program.
Converged Risk leverages Inovalon’s industry-leading data assets and advanced analytic capabilities to improve member and provider experience, disease documentation, and coding accuracy while ensuring compliant program execution.
Inovalon’s offers a custom experience – via an intuitively designed user interface – by combining secure user roles with access to real-time reporting, 24/7/365, on any device.
Seamlessly stratify entire populations based on patient conditions and confidence thresholds, with metrics such as risk score opportunity, trend, forecasting, and recapture rates.
Prioritize and allocate resources, in-year, based on forecasted PMPY impact by HCCs, population and/or demographic segmentation, providers, and more.
Create tailored worklists by quickly identifying, researching, and exporting member and provider level details across entire populations.
Design and share custom measure strategies to advance priority healthcare initiatives for improved outcomes and performance.
Reduce the burden of manual and ad-hoc reporting with versatile, purpose-built software for health plan data management initiatives – all while gaining a more comprehensive view.
Deliver complete, accurate, secure submissions, on-time and with fewer errors for Medicare EDS and ACA EDGE Server.